Fatal pulmonary sporotrichosis caused by Sporothrix brasiliensis in Northeast Brazil

A relevant case of pulmonary sporotrichosis due to Sporothrix brasiliensis is reported in a 50-year-old immunocompetent woman who had no history of skin trauma, but was in close contact with several stray cats at her nap time. The patient was hospitalized after 7 months of illness. The survey was co...

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Published in:	PLoS neglected tropical diseases 2020-05, Vol.14 (5), p.e0008141-e0008141
Main Authors:	do Monte Alves, Manoella, Pipolo Milan, Eveline, da Silva-Rocha, Walicyranison Plinio, Soares de Sena da Costa, Alexandre, Araújo Maciel, Bruno, Cavalcante Vale, Pedro Henrique, de Albuquerque, Paulo Roberto, Lopes Lima, Soraia, Salles de Azevedo Melo, Analy, Messias Rodrigues, Anderson, Chaves, Guilherme Maranhão
Format:	Article
Language:	eng
Subjects:	Abdomen Alveoli Amphotericin B Biology and Life Sciences Bronchus Case studies Causes of Cavitation Diagnosis Disease DNA Epidemiology Fungal infections HIV Human immunodeficiency virus Lipids Lung diseases Lung nodules Medicine and Health Sciences Molecular chains Nodules Nucleotide sequence PCR People and places Polymerase chain reaction Research and Analysis Methods Signs and symptoms Skin Species Sporothrix brasiliensis Sporotrichosis Supervision Surveying Symptoms Thromboembolism Trauma Tuberculosis
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Summary:	A relevant case of pulmonary sporotrichosis due to Sporothrix brasiliensis is reported in a 50-year-old immunocompetent woman who had no history of skin trauma, but was in close contact with several stray cats at her nap time. The patient was hospitalized after 7 months of illness. The survey was conducted for pulmonary tuberculosis, an endemic disease in Brazil. She presented multiple central pulmonary nodules images, with central cavitation. The patient bronchoalveolar lavage was cultured and Sporothrix sp. growth was obtained. Then, the isolate (LMMM1097) was accurately identified to the species level by using species-specific polymerase chain reaction (PCR). Molecular diagnosis revealed that the emerging species Sporothrix brasiliensis was the agent of primary pulmonary sporotrichosis and the patient was treated with Amphotericin B lipid complex, but presented severe clinical symptoms and the fatal outcome was observed at day 25 after hospitalization. Our report adds important contributions to the clinical-epidemiological features of sporotrichosis, showing the geographic expansion of the agent within different regions of Brazil and a rare clinical manifestation (primary pulmonary sporotrichosis) caused by the emerging agent S. brasiliensis in an immunocompetent female patient.
ISSN:	1935-2735 1935-2727 1935-2735